| NPI | 1194070235 |
|---|---|
| Former Name | LACEY JAY ROACH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: AZ S019202) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: IA 21887) |
| Enumeration Date | 2012-07-15 |
| Last Update Date | 2022-06-14 |